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Innkeeper Nathaniel Dwight is incensed with Elihu Ashley for two reasons: he believes Ashley has infected his young granddaughter with smallpox and he wants to be compensated for the money he has had to spend for her medical care. Ashley, who was serving as physician in Worthington, Massachusetts, following his training in Deerfield, Massachusetts, has recently been inoculated for smallpox and has stopped at Dwight's hostelry in Belchertown, Massachusetts, where he has inadvertently left his coat. When he attempts to retrieve the coat, the landlord accuses him of infecting the premises and causing the illness of his granddaughter. The tone of the letter indicates the fear of smallpox and its pervasiveness among the population at a time when inoculation was new.